Dr. Stanley Smith holds a photo of his sister, Dorothy Ann Johnson, and her son, Shannon, close to his heart.
Dr. Stanley Smith holds a photo of his sister, Dorothy Ann Johnson, and her son, Shannon, close to his heart.
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UMMC researcher asks colleagues to heed screening call

Published on Thursday, March 22, 2018

By: Cynthia Wall

When a University of Mississippi Medical Center colleague began organizing a statewide group to help lower colorectal cancer deaths, Dr. Stanley Smith didn’t suspect he’d be a beneficiary.

Now, the UMMC associate professor of pharmacology and toxicology said his first colorectal cancer screening in early 2016 freed him from polyps and worry.

For years, Smith said, he’d postponed requests from his doctors to have the screening, instead focusing on ailing parents, a then new job at UMMC and his research.

Today he calls the procedure one that was “very professionally done.”

Smith and his siblings are considered at high risk since their sister, Dorothy Ann Johnson, died of colorectal cancer at age 48 and because they’re African American. After Johnson’s death in 2000, Smith’s doctors urged him to be screened at 40.

Portrait of Roy Duhe

At 50, he found himself down the hall from Dr. Roy Duhe, professor of pharmacology and toxicology, who leads a statewide effort, the 70x2020 Colorectal Cancer Screening Initiative, to see 70 percent of eligible Mississippians’ screened by 2020.  Duhe is a member of the UMMC Cancer Institute’s Population Science Research Program.

“Roy has always been enthusiastic about screening,” Smith said. Soon after that conversation, Dr. LouAnn Woodward, the Medical Center’s top executive, used her Friday VC Notes column to urge UMMC employees to be screened.

“It was on my radar so I decided it was just time to get it done,” Smith said.

Today, he urges others to heed those warnings: “The consequences of not doing it are very unforgiving. It is a pain-free procedure and gives you an answer. You know and can move on with life until the next screening.”

Smith said UMMC doctors alleviated his fears.

“I have problems with anesthesia and they were very willing to adapt the protocols for me,” he said.

“The value of the data you are receiving is very important,” he said.

Woodward signed the 80x2020 pledge in October 2015.
Dr. LouAnn Woodward signs the Colorectal Cancer 80x2020 Pledge in October 2015.

In 2015, Woodward also signed the National Colorectal Cancer Roundtable pledge saying UMMC would work to achieve 80 percent compliance with colorectal screening guidelines by 2018. 

In that 2015 column, she urged UMMC employees age 50 and older to be screened and offered this reminder:  “Remember that CRC screening is a covered benefit for all our employees who participate in the State and School Employees' Health Insurance Plan.”

Recently published research confirms earlier estimates that colonoscopies can reduce colorectal cancer incidence and deaths. The study published in March in the Annals of Internal Medicine, examined Veterans Affairs data from the Centers for Medicare and Medicaid Services. Investigators found a 61 percent reduction in CRC mortality linked to those who had a colonoscopy.

Doctors here have always said more screening means fewer deaths.

Dr. Shannon Orr, assistant professor of surgery, also faced starting screening early because of a family history of colorectal cancer. To celebrate his 40th birthday, he scheduled a colonoscopy with Dr. James Sones, professor and chief of the Division of Digestive Diseases.

“Colorectal cancer is mostly a preventable cancer if you catch it early by screening,” said Orr. “I also thought that being the lead on the gastrointestinal team, I could set an example by getting it done.”

Dr. Shannon Orr, who leads the UMMC Cancer Institute team that treats colon cancer had his colonoscopy early based on a family history of the disease. He shows results here, including photos of a few polyps before they were removed.
Dr. Shannon Orr shows photos of a few of his polyps before they were removed.

Orr leads the UMMC Cancer Institute’s Interdisciplinary Gastrointestinal Cancer Program whose members meet weekly to review and discuss the best treatment for each new patient with a GI cancer.

“It would be nice if I didn’t have a job taking out colorectal cancers,” he said.

The most commonly used screening options are colonoscopy and stool tests. In a colonoscopy, doctors can remove any polyps or suspicious tissue they find. If a stool test or a stool/DNA test reveals blood or markers, then doctors may recommend a colonoscopy.

Sones, who has spent decades performing colonoscopies, fears excuses overcome need for too many people.

James Sones

He estimates he finds polyps, or small, wart-like protrusions, in 20-30 percent of his patients. “You’ll find 10 or 15 in one patient and go five or six patients without finding any,” he said.

Removing polyps can prevent colon cancer. Undetected they can become malignant.

No excuse is strong enough to delay a screening that could prevent cancer, he said.  

“That’s the saddest thing in the world to see someone who delayed being screened and they come in because they have blood in their stool and you find out they have colon cancer,” he said.

“This is the only cancer you can prevent by taking a day out of your life and having a test every few years. Other cancers are discovered when they’re advanced. You can find this one before you have symptoms,” he said.

He said he’s heard all the colonoscopy excuses ranging from fear it will hurt to dreading the preparation to just saying they’re too busy. He counters each: the prep is easier now; doctors make sure it doesn’t hurt; no amount of time lost for this test is worth getting colon cancer.

As efforts to increase screening enter its fourth year, Duhe, said the state is seeing some progress, just not fast enough. When it started in 2014, the Behavioral Risk Factor Surveillance System’s 2012 survey showed 58.8 percent of Mississippians reported being screened in the past year with a fecal occult blood test or in the past 10 years with a sigmoidoscopy or colonoscopy. In 2016, those BRFSS numbers were up to 63.8 percent.

That’s short of the 70 percent goal the more than 650 members of the 70x2020 Initiative hope to achieve, said Duhe.

Screening can save lives, Duhe said. The Centers for Disease Control estimates screening could prevent up to 60 percent of deaths from colorectal cancer. In Mississippi adequate screening could save hundreds of lives.

The Mississippi Cancer Registry shows that in 2015, 1,713 Mississippi residents were diagnosed with colorectal cancer and 610 died of it.

Duhe also asks that Mississippians who are younger than 50 or who have already been screened to encourage a loved one who is 50 or older to be screened. Smith said he’s taking that message to his family and friends.